Why isn’t anyone keeping track of the number of homeless people dying in Pierce County?
There is no definitive data on the number of people who died while living unhoused on the streets of Pierce County in 2024. While public health agencies say the data is difficult to collect and produce, advocates say the gap prevents public-health solutions for a vulnerable population.
The News Tribune requested data on the number of people died while living homeless in Pierce County in 2024 from the Washington State Department of Health, Tacoma-Pierce County Health Department and the Pierce County Medical Examiner’s Office.
No agency was able to provide a complete or comprehensive set of data for the region, and representatives from each one seemed to name different agency when asked who’s role it was to collect such data.
Those headquartered in Pierce County pointed The News Tribune to one man.
Counting the dead
Local chaplain Ed Jacobs has been conducting memorial services to honor those who have died while living unhoused on the streets of Pierce County for years. He organizes memorial services four times a year and relies on a quarterly report from the Pierce County Medical Examiner’s Office as well as the Tacoma-Pierce County Health Department (TPCHD) to inform him of the number of individuals who perished and their names.
In 2023, he was informed of nearly 300 people who died while living homeless, but in 2024 something changed.
Jacobs told The News Tribune that the number of deaths reported to him began to shrink drastically beginning in March 2024.
“All of a sudden deaths were fewer,” he told The News Tribune in an interview. “It was a strange situation.”
Jacobs was skeptical that fewer people were dying on the streets and believed it was more likely due to a change in how the county was reporting or collecting the numbers.
Jacobs, said TPCHD informed him that health departments across the state had adopted a new system for recording death certificates around the time he started receiving lower death counts from the department.
According to Jacobs, the department reported an average of about 35 deaths per quarter previous to 2024. During 2024 he started to receive death counts near zero.
A registrar from the department told The News Tribune the new system did not allow officials to easily identify who was unhoused at the time of their death.
Kenny Via is a spokesperson for the Tacoma-Pierce County Health Department. When asked for data on the number of individuals who died while living unhoused in 2024, Via said the department relies on data from the Pierce County Medical Examiner’s Office and had not yet begun a data analysis for 2024.
“Our data team tracks this information by analyzing records from the Pierce County Medical Examiner’s Office. Homelessness status is sometimes available for deaths the [Medical Examiner’s Office] investigates,” Via told The News Tribune in an email. “We use this information to assess trends over time, but it does not allow us to measure the total number of deaths among people experiencing homelessness in Pierce County. “
Angel Tornquist, administrative program manager for the Pierce County Medical Examiner’s Office, said it “likely impossible” to confirm with certainty that a decedent was unhoused at the time of death.
“For cases reported to the Medical Examiner in which we accept jurisdiction and conduct an investigation, if a residence address is unknown/no fixed address/no permanent address/transient/presumed to be homeless, we will indicate that in our case database,” she told The News Tribune in an email.
Tornquist said the Medical Examiner’s Office often relies on witnesses to inform them of an individual’s living situation at the time of their death. The office also might use information from first responders and law enforcement who occasionally are familiar with the deceased person and might report that the person was known to be unhoused.
Who’s Responsibility is it?
Luke Vogelsberg is the director of operations for the Pierce County Medical Examiner’s Office. In an interview with The News Tribune, Vogelsburg said the Medical Examiner’s Office only investigates deaths deemed to be “unnatural,” so if a person who was living unhoused dies in the hospital of an illness such as cancer, the death would not be reported to the office or investigated.
He also said it is not necessarily the role of the Medical Examiner’s Office to determine whether a person was homeless at the time of their death.
“It is not pertinent to our investigation,” he told The News Tribune.
Tornquist and Vogelsburg told The News Tribune the health department would have the most accurate aggregate data on homeless deaths.
When The News Tribune requested that data from the Washington State Department of Health, it was told it would need to get it from the Tacoma-Pierce County Health Department.
After requesting the data from the Tacoma-Pierce County Health Department, The News Tribune was told the department did not have a way of producing the data. A registrar from the department informed the newspaper that the data was not accessible due to a change in the state’s death data management system that did not allow for filtering of homeless deaths.
The registrar referred The News Tribune to Jacobs for more information on those who have died while living unhoused in Pierce County.
Why it matters
This gap in data has Jacobs and some public-health advocates concerned.
“Somebody has to be able to report homeless deaths,” Jacobs said. “How are we going to be able to tell the federal government we need funding because people are dying on the streets?”
Tom Langdon Hill is medical sociologist with Certified Community Health Specialists (CCHS), a national network of healthcare clinicians focused on improving access to healthcare for individuals experiencing homelessness.
In an interview with The News Tribune, Hill said the homeless death data gap is not unique to Pierce County. He said it is a metric that was not tracked at all a decade ago, and tracking only ramped up around the time of the COVID-19 pandemic.
He said the federal government began to take interest in it when it established programs to address the unhoused veteran population.
Hill said tracking the number of homeless deaths and the cause of those deaths is important to be able to recognize public health patterns — such as pathogenic infections that unsheltered people are more vulnerable to as well as other patterns that could inform public health decisions.
Hill said that typically, people living unhoused experience much higher rates of mortality.
A study done by researchers in Santa Clara County, California, found that individuals living unhoused were dying 20 years earlier than the housed population with higher rates of injurious, treatable and preventable causes.
According to the study, The proportion of deaths related to substance-use, illness, injury, homicide and suicide was nine times higher in the unhoused cohort compared to the housed cohort.
Hill said without good data on what is causing premature deaths of those living unhoused, we are unable to assess the “extent of the problem” and how to solve it.
“In many ways we are missing what is killing homeless people,” he told The News Tribune.
